As medical and hospital costs continue to increase, surgeons are constantly striving to develop advanced surgical techniques. Advances in the surgical field are often related to the development of operative techniques which involve less invasive surgical procedures and reduce overall patient trauma. In this manner, the length of hospital stays can be significantly reduced, and therefore the hospital and medical costs can be reduced as well.
One of the truly great advances in recent years to reduce the invasiveness of surgical procedures is endoscopic surgery. Endoscopic surgery involves the use of an endoscope, which is an instrument permitting the visual inspection and magnification of any cavity of the body. The endoscope is inserted through a tube, conventinally referred to as a cannula, after puncture of a hole into the soft tissue protecting the body cavity. The hole is made with a trocar, which is a sharp-pointed instrument. The trocar includes an obturator, or cutting implement, which is slideably and removeably disposed within a trocar cannula. The obturator will puncture a hole in the tissue equal in size to the inner diameter of the trocar cannula. After puncture, the obturator can be slideably withdrawn from the trocar cannula. The surgeon can then perform diagnostic and therapeutic procedures at the surgical site with the aid of specialized instrumentation designed to fit through trocar cannula and additional trocar cannulas providing openings into the desired body cavity as may be required.
In many surgical procedures, including those involving endoscopic surgery, it is often necessary to ligate blood vessels which have been cut within the surgical site. The vessels may then be severed downstream of the ligated portion. The primary reason for ligating the vessels is to maintain the surgical site free of an excess of blood and to reduce blood loss in the patient.
Conventionally, surgeons have closed blood vessels with ligatures, which are long, relatively straight strands of suture material. The surgeon manually ties the ligature around the vessel desired to be closed. Unfortunately, conventional ligatures are not well suited for endoscopic surgical applications where a surgeon's manual operative techniques within the surgical site are severely restricted.
In more recent years, a ligature has been developed which is better adapted for endoscopic surgery. ENDOKNOT gut ligature is a device formed from a suture material of surgical catgut. The catgut ligature is securely fastened within a cannula at one end and attached to a needle at the other end. As is described and illustrated in more detail herein with respect to the drawings of this prior art device, although ENDOKNOT gut ligature facilitates ligation of vessels through small incisions in bodily cavities, the surgeon is required to manually tie the ligature knot extracorporeally, i.e. outside the body, to ligate a vessel. This is a time consuming and laborious process, especially for inexperienced surgeons, and represents a significant disadvantage to the use of the ENDOKNOT ligature device.
In view of the significant deficiency of the prior art, an endoscopic ligature which avoids the necessity of manual knot-tying extracorporeally would be highly desired within the medical community.